Medical Emergencies
What you do during the time it takes an Emergency Medical Services (EMS) unit to reach a sick or injured person can save his or her life. This page outlines some of the major dos and don'ts of first aid:
- Do get some emergency medical training. A bit of your time could save a life.
- Do take a CPR class. Heart Disease is the nation's #1 killer. Without bystander CPR, EMS rarely arrives in time to save a life!
- Do not panic. Getting a little training can help you to remain calm and be a part of the solution. The American Medical Association, the American Heart Association, and the American Red Cross have worked together to come up with a concept called "the Chain of Survival." This concept is based on the idea that survival of cardiac arrests (and by extension, survival of medical emergencies in general) is dependent upon four major steps:
- Early access to EMS: call 9-1-1 as soon as you realize that a person needs help.
- Early CPR: if CPR is not begun quickly, brain cells will die, and it becomes almost impossible to return the patient to a normal lifestyle.
- Early defibrillation: A defibrillator is a device which, via electric shock, can restart a stopped heart. The faster the device is applied the more effective it is. However, if no one did CPR, the patient may have brain damage.
- Early advanced care - once the heart is restarted, advanced medical care is necessary to maintain the life.
For ambulance, fire, or police services, the number to call is 9-1-1. You do not need an outside line, nor do you need change for pay phones (inside the hospital complex, dial 1-2-3).
So, let's take a brief moment to consider some emergency steps you can accomplish, even if you have not yet taken a CPR course. Choose from the following topics: ABCs of Lifesaving, Heart Attack, Bleeding, Burns, Seizures, Diabetic Emergencies, Bone and Joint Injuries, and Spinal Cord Injuries.
ABCs of Lifesaving
Thousands of people die in emergency situations every day. Don't be one of them! Before you rush in to help, take a moment to be sure that the area is safe. If it is not safe, get out and call 9-1-1.
- Assess: Determine if a person needs your help. Try asking them something like "Are you O.K.?"
- Get help: If the patient is unresponsive, call 9-1-1 immediately, even if you must briefly leave the patient to do so. If another person is around send him or her to call while you stay with the patient.
- Airway: Open the airway if the patient is unresponsive. Place the fingers of one hand under the patient's chin and the other on the forehead. Push up on the chin and down on forehead, tipping the head back (gently!) and pushing the jaw upward. Put your ear near their mouth, turning your head so you can see the patient's chest. Look, listen and feel for breathing for 3 to 5 seconds.
- Breathing: Attempt mouth-to-mouth breathing if patient is not breathing. With airway open, pinch patient's nostrils shut with the index finger and thumb of the hand that is holding the forehead back.
- Take a deep breath, open your mouth wide and seal it tightly over the patient's mouth. Give 2 full, slow breaths then 1 breathe every 5 seconds for adults. Each breath should take you about 2 seconds. Watch the chest to see if it rises and falls.
- Circulation: If the heart is not beating, you need to circulate the patient's blood manually. This technique is called CPR and should only be used by those who have completed a CPR course. If you are not CPR trained, calling 9-1-1 is still beneficial, so don't delay!
Heart Attack
A heart attack occurs when an artery in the heart becomes blocked or damaged, thus preventing the flow of oxygenated blood to the heart muscle itself. The part of the deprived heart muscle dies from this lack of oxygen. This tissue death is what we call a "heart attack." If the artery is narrowed, but tissue death is not occurring, a person may exhibit all of the signs and symptoms of a heart attack anyway. This is a condition called "Angina Pectoris" and, without medical tests it is virtually impossible to differentiate the two. Because some 500,000 people in the U.S. die each year from heart attack, nearly two-thirds of whom die before receiving medical care, it is imperative that you know how to recognize a heart attack and know what to do.
- Symptoms: Dull pain in the chest radiating to arms, jaw, or back, that may be "crushing." Difficulty breathing, nausea, vomiting, sweating, anxiety, and denial are common.
- Treatment: Have the patient lie or sit down right where they are. Try to keep the patient calm. Do not attempt to transport the patient yourself. Call 9-1-1 for help.
Bleeding
Your blood transports oxygen to your cells, and removes wastes from the cells. If a person is bleeding badly, the tissues of the body will not be properly perfused. This is a condition called "shock," and it is life threatening. Treating bleeding is one of the most important skills you can learn. The concepts are easy, and are explained here, but take the time to get trained in first aid so that you will be better able to cope with these emergencies.
To control bleeding:
- Direct pressure: Apply direct pressure over the wound to control bleeding. Place a sterile dressing over the wound if you have one available. If you don't have sterile first aid supplies, use a clean cloth, or your bare hand.
- Note: While the risk of disease transmission is slight, placing a barrier between your skin and the patient's blood is a wise idea. Use latex, vinyl, or rubber gloves if possible. Any barrier is better than none. Also, whenever you render medical assistance, be sure to wash your hands thoroughly when finished. Do not remove dressing if it becomes blood soaked. Apply an additional dressing instead. Don't release pressure until help arrives.
Burns
Be sure the fire is out; remember, your own safety must come first.
- First degree: These are the least serious burns. Superficial tissue damage results in reddened skin, minor swelling, and pain. Treat them by cooling the burned area with cool water.
- Second degree: More serious, these burns cause deeper tissue damage, red skin, blisters, and pain. If the blisters are broken, do not use water (unless needed to put out the fire). Apply moist, sterile dressings. If the blisters are not broken, don't break them! Apply cool water as for a first degree burn, and then moist sterile dressings.
See a physician at once if the burns are to the face, palms, or genitals or between fingers or toes or the inside of any joint.
- Third degree: These are the most serious with very deep tissue damage, and even tissue burned away to ash. Even the smallest burn of this type needs to be evaluated by a doctor. Also, you should treat for shock and keep the airway open. Do not cool off burned area with water unless you need to put out the fire.
Call 9-1-1 anytime a person has second or third degree burns to the mouth (the airway may also be burned) or to an area that is equal in size to an extremity. Any time a burned patient has been trapped inside an enclosed space, call 9-1-1 as well. If you are not sure if you should call 9-1-1, then you probably should call! Do not use any type of ointment on burns, unless directed to do so by a physician.
Seizures
Seizures are characterized by a series of uncontrolled muscle movements or loss of responsiveness. Not all seizures are the result of epilepsy, although epileptics are often the patient of seizures - particularly if they have not taken their medicine or if something has happened to make their medicine less effective. Because of this, we recommend that you do call 9-1-1 for any person having a seizure.
There are some general first aid guidelines for seizures however:
- During seizure: Keep the patient from hurting themselves by moving furniture or loose heavy objects away. Do not restrain patient. Ever. Do not put anything in patient's mouth. Ever.
- After seizure: Keep the airway open if patient is unresponsive. Be supportive, and keep onlookers away. The patient may be disoriented when he/she awakens.
Diabetic Emergencies
Diabetes is a disease in which a person cannot manufacture insulin. Insulin is a hormone responsible for getting sugars from the foods you eat from your blood to your brain. Most diabetics are able to control their condition through medication and/or diet. However, if their balance between insulin and sugar is off, the person will experience possibly life-threatening consequences.
Hyperglycemia: Caused by too much sugar in the blood stream, the patient may appear confused, drowsy, or unconscious and have a peculiar "fruity" odor to their breath. This condition is slow to manifest, and early symptoms may resemble those of the flu. After the situation gets worse, the patient may become disoriented and later fall into unconsciousness followed by death. Call 9-1-1; this person needs immediate hospital treatment. Do the ABCs of lifesaving if patient is unresponsive.
Hypoglycemia: Caused by too little sugar in the blood stream, this problem comes on rather rapidly. Often, the diabetic person will know what's coming and eat or drink something to restore the balance. If the patient does not restore the balance, he or she may progress to an appearance of intoxication. Left uncorrected, the person will lose consciousness and eventually die. Give the patient sugar or something with sugar in it, if the patient is alert and able to protect their own airway. Call 9-1-1 if the person does not respond to the sugar or is not alert. Do the ABCs of lifesaving if patient is unresponsive.
Never put anything into the mouth of an unconscious person!
Injuries to Bones and/or Joints
Though common, bone and joint injuries can be far more serious than people realize. Nerves and blood vessels travel alongside bones and through the capsules of joints: should the bone be injured, damage to the nerves can be permanent. Large amounts of blood can be lost due to fractures, and damage to the connective tissues of joints can lead to long-term disability. Therefore, appropriate treatment for these common injuries should be stressed.
- Keep patient comfortable.
- Control any bleeding. Elevate injured extremities slightly if it does not cause additional pain to do so.
- If available, an ice pack (covered by a thin cloth to prevent freezing the skin) may be applied to the injured area to help relieve pain and reduce swelling.
- Do not push broken bone ends back through skin.
- Do not try to straighten out an arm or leg if it appears deformed.
- While we recommend that you call 9-1-1 and let the pros handle these injuries, if you do decide to take the person to the doctor yourself, immobilize the area with a comfortable but rigid splint. The splint should prevent movement of the injured area and the joints immediately above and below the injury. Do not tie a splint too tightly, and be sure that you can see the patient's fingers or toes on the extremity so that you can ascertain if the person can move them before and after you splint. Take a first aid course to learn how to splint safely. Call 9-1-1 if you are unsure how to proceed.
Spinal Injury
Perhaps the most feared result of trauma is the permanent paralysis that can occur if a person with an injured spine is moved improperly.
- Always assume that a person has an injured spine if they have been in a car accident (more than a fender bender) or have fallen from any height greater than their own shoes, or are unconscious due to injury, or if they have received an injury which penetrates into the body anywhere above the imaginary line drawn between their nipples.
- Also assume spinal injury if the person complains of pain in their neck, numbness or tingling or inability to move a part of their body following any accident or injury.
- Do not move patient or allow anyone else to move them.
- Do necessary first aid without moving the patient more than necessary. Note that if the person is unresponsive, you may need to move them in order to do the ABCs of lifesaving. In this case move the person as a unit and as little as possible. I you take a first aid class, you will learn ways of minimizing the movement. Call 9-1-1.
Obviously, this page only covers a few items of concern in first aid care. Please remember that while we believe everything here to be accurate at this time, medicine is a constantly-changing field. Please find some time in your schedule to take a CPR course and a first aid course.
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Helpful Links & Info
The Emergency Procedures Guide is a good campus emergency information desk reference. Download this document for immediate access in the event of an emergency.
Emergency Response Procedures Guide |
